Thyroid peroxidase antibodies do not impair the ovarian reserve in euthyroid women: a cross-sectional study.

Aim: This study aims to investigate whether thyroid peroxidase antibodies (TPOAb) affect the ovarian reserve using the anti-Müllerian hormone (AMH), basal follicle-stimulating hormone (bFSH), and estradiol (bE2) as markers.

Methods: A large retrospective cross-sectional study was conducted, including women who visited our clinic between May 2016 and April 2024 and underwent same-day assessments of basal sex hormones, thyroid function, and AMH. Women with thyroid cancer, ovarian cancer, or clinical/subclinical hypo- or hyperthyroidism were excluded. Participants were stratified into TPOAb-positive and TPOAb-negative groups. Ovarian reserve markers and thyroid function were compared between the groups, and the impact of TPOAb positivity on ovarian reserve was analyzed.

Results: Totally, 3,465 women were eligible for analysis, 2,992 women were TPOAb-positive, and 543 (15.67%) were TPOAb-negative. Compared with the TPOAb-negative group, the median age of the TPOAb-positive group was significantly older (33.0 vs 32.0) (P = 0.008), and the median serum TSH levels were significantly higher (1.56 vs 1.40) (P = 0.0003). However, FT4, AMH, bFSH, and bE2 levels did not demonstrate any difference between the two groups. Multivariable median regression models showed that different TPOAb titers had no effect on serum AMH, bFSH, and bE2 levels. Age-stratified analysis showed no association of TPOAb positivity with AMH, bFSH, and bE2 levels in different age groups.

Conclusion: Our study indicates that TPOAb positivity is highly unlikely to impair the ovarian reserve in euthyroid women of reproductive age. A larger prospective cohort study on population should be conducted to determine this issue.